Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease. Less than 10% of all dementias are reversible. Dementia is a non-specific term that encompasses many disease processes, just as fever is attributable to many etiologies.

Early symptoms of dementia often consist in changes in personality, or in behavior. Often dementia can be first evident during an episode of delirium. There is a higher prevalence of eventually developing dementia in individuals who experience an acute episode of confusion while hospitalized.

Dementia can affect language, comprehension, motor skills, short-term memory, ability to identify commonly used items, reaction time, personality traits, and executive functioning. Even without signs of general intellectual decline, delusions are common in dementia (15-56% incidence rate in Alzheimer’s type, and 27-60% incidence rate in multi-infarct dementia). Often these delusions take the form of monothematic delusions, like mirrored self-misidentification.

Elderly people can also react with dementia-like symptoms to surgery, infections, sleep deprivation, irregular food intake, dehydration, loneliness, change in domicile or personal crises. This is called delirium, and many if not most dementia patients also have a delirium on top of the physiologial dementia, adding to the symptoms.

The delirium can go away or greatly improve when treated with tender care, improved food and sleeping habits, but this does not affect the alterations in the brain. Affected persons may also show signs of psychosis or depression. It is important to be able to differentiate between delirium and dementia.

Proper differential diagnosis between the types of dementia will require, at the least, referral to a specialist, e.g. a geriatric internist, geriatric psychiatrist or neurologist. However, there are some brief 5-15 minute tests that have good reliability and can be used in the office or other setting to evaluate cognitive status.

Except for the treatable types listed above, there is no cure to this illness, although scientists are progressing in making a type of medication that will slow down the process.

A moderate but regular exercise program appears to be the key to staying young at any age. Exercise has been shown to have an amazing positive effect on almost every aspect of middle-aged health, from lowering blood pressure to raising endurance and alertness. Studies all over the world have shown that exercise during middle age can stabilize blood sugar levels and help control adult-onset diabetes. It also increases bone density, dramatically reduces cardio-vascular risk, and lowers cholesterol.

Exercise has even been demonstrated to be a significant factor in avoiding the onset Alzheimer’s Disease. Older adults who exercise at least three times a week are almost 40% less likely to be diagnosed with the disease than those who don’t exercise.

Another exciting finding is that there doesn’t seem to be any “cutoff” age for experiencing the benefits of regular exercise. Study participants from age 40 to 90 all showed measurable and even startling improvements in health, strength, and mental clarity as a result of exercise.

Even the most apparently age-related problems of all, menopause and andropause (or “male menopause”), respond favorably to a regular exercise program. Middle aged female study participants who exercised at least three times a week reported a marked reduction in the uncomfortable symptoms of menopause, and recent research by the New England Research Institutes in Massachusetts suggest that lack of exercise and the resulting weight gain can significantly increase the amount of testosterone men lose during middle age. By exercising regularly and maintaining fitness over 50, it’s possible that midlife men could improve mental clarity, increase energy, and enhance sexual function.

The best news of all is that realizing the dramatic benefits of over 50 fitness doesn’t require an intensive or rigorous regimen. Moderate exercise done regularly at least three times a week is enough to get the anti-aging process going.